Improvement scoring of the Rey Auditory Verbal Learning Test

The objective was to test the validity of serial position effects (SPE’S) scoring of the Rey Auditory Verbal Learning Test. The RAVLT, a multi-trial free recall test, is a much used clinical method for assessing memory performance. The method of scoring, however, obfuscates that two memory functions underlie free recall. This is suggested by serial position effects (SPE’S) of single-trial free recall, although the extent of the effects is not defined. Research is reviewed in which the internal and external validity of SPE’S of the RAVLT is studied. The internal validity of SPE’S was tested by means of confirmatory factor analysis. It is shown that the recency effect comprises the last two to three items, while the primacy and middle (prerecency) effect comprise the remaining items in a list, implying that they arise from two memory functions. Studies testing their external validity show that they play a variant role in memory impairment of AD and MD patients and are found to be differentially related to stress hormones activity in these patients, and in healthy human subjects. Scoring of accurately determined SPE’S in the RAVLT is a valid improvement of clinical memory assessment. Their neuropsychological significance is discussed.